<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-user_id" data-rule="required" min="0" data-source="user/user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="{$row.user_id|htmlentities}">-->
<!--        </div>-->
<!--    </div>-->
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" class="form-control" name="row[name]" type="text" value="{$row.name|htmlentities}">
        </div>
    </div>

<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Number')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-number" class="form-control" name="row[number]" type="text" value="{$row.number|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Fullname')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-fullname" class="form-control" name="row[fullname]" type="text" value="{$row.fullname|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Phone')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-phone" class="form-control" name="row[phone]" type="text" value="{$row.phone|htmlentities}">
        </div>
    </div>
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Money')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-money" class="form-control" step="0.01" name="row[money]" type="number" value="{$row.money|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->

    {if condition="$row.is_identity == 1"}
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Gender')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-gender" class="form-control" name="information[gender]" type="text" value="{$information.gender_text|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Age')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-age" class="form-control" name="information[age]" type="text" value="{$information.age|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Idnumber')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-idnumber" class="form-control" name="information[idnumber]" type="text" value="{$information.idnumber|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Wechat_number')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-wechat_number" class="form-control" name="information[wechat_number]" type="text" value="{$information.wechat_number|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Mailbox')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-mailbox" class="form-control" name="information[mailbox]" type="text" value="{$information.mailbox|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Intention_city_id')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-intention_city_id" class="form-control" name="information[intention_city_id]" type="text" value="{$information.intention_city_id|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Intention_hospital')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-intention_hospital" class="form-control" name="information[intention_hospital]" type="text" value="{$information.intention_hospital|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Idnumber_just_image')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <ul class="row list-inline faupload-preview" id="p-idnumber_just_image">-->
<!--                <li class="col-xs-3">-->
<!--                    <a href="{$information.idnumber_just_image|htmlentities}" data-url="{$information.idnumber_just_image|htmlentities}" target="_blank" class="thumbnail">-->
<!--                        <img src="{$information.idnumber_just_image|htmlentities}" onerror="this.src='/juhui_sys.php/ajax/icon?suffix=jpg';this.onerror=null;" class="img-responsive">-->
<!--                    </a>-->
<!--                </li>-->
<!--                <li class="col-xs-3">-->
<!--                    <a href="{$information.idnumber_back_image|htmlentities}" data-url="{$information.idnumber_back_image|htmlentities}" target="_blank" class="thumbnail">-->
<!--                        <img src="{$information.idnumber_back_image|htmlentities}" onerror="this.src='/juhui_sys.php/ajax/icon?suffix=jpg';this.onerror=null;" class="img-responsive">-->
<!--                    </a>-->
<!--                </li>-->
<!--            </ul>-->
<!--        </div>-->
<!--    </div>-->
    {elseif condition="$row.is_identity == 2"/}
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Coprorate_name')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-coprorate_name" class="form-control" name="information[coprorate_name]" type="text" value="{$information.coprorate_name|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Coprorate_code')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-coprorate_code" class="form-control" name="information[coprorate_code]" type="text" value="{$information.coprorate_code|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Bus_address')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-bus_address" class="form-control" name="information[bus_address]" type="text" value="{$information.bus_address|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Duty_paragraph')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-duty_paragraph" class="form-control" name="information[duty_paragraph]" type="text" value="{$information.duty_paragraph|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Duty_coprorate_name')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-duty_coprorate_name" class="form-control" name="information[duty_coprorate_name]" type="text" value="{$information.duty_coprorate_name|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Opening_bank')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-opening_bank" class="form-control" name="information[opening_bank]" type="text" value="{$information.opening_bank|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Corporate_account')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <input id="c-corporate_account" class="form-control" name="information[corporate_account]" type="text" value="{$information.corporate_account|htmlentities}" readonly="readonly">-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('License_image')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <ul class="row list-inline faupload-preview" id="p-license_image">-->
<!--                <li class="col-xs-3">-->
<!--                    <a href="{$information.license_image|htmlentities}" data-url="{$information.license_image|htmlentities}" target="_blank" class="thumbnail">-->
<!--                        <img src="{$information.license_image|htmlentities}" onerror="this.src='/juhui_sys.php/ajax/icon?suffix=jpg';this.onerror=null;" class="img-responsive">-->
<!--                    </a>-->
<!--                </li>-->
<!--            </ul>-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Permit_image')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <ul class="row list-inline faupload-preview" id="p-permit_image">-->
<!--                <li class="col-xs-3">-->
<!--                    <a href="{$information.permit_image|htmlentities}" data-url="{$information.permit_image|htmlentities}" target="_blank" class="thumbnail">-->
<!--                        <img src="{$information.permit_image|htmlentities}" onerror="this.src='/juhui_sys.php/ajax/icon?suffix=jpg';this.onerror=null;" class="img-responsive">-->
<!--                    </a>-->
<!--                </li>-->
<!--            </ul>-->
<!--        </div>-->
<!--    </div>-->
<!--    <div class="form-group">-->
<!--        <label class="control-label col-xs-12 col-sm-2">{:__('Qualifications_images')}:</label>-->
<!--        <div class="col-xs-12 col-sm-8">-->
<!--            <ul class="row list-inline faupload-preview" id="p-qualifications_images">-->
<!--                <li class="col-xs-3">-->
<!--                    <a href="{$information.qualifications_images|htmlentities}" data-url="{$information.qualifications_images|htmlentities}" target="_blank" class="thumbnail">-->
<!--                        <img src="{$information.qualifications_images|htmlentities}" onerror="this.src='/juhui_sys.php/ajax/icon?suffix=jpg';this.onerror=null;" class="img-responsive">-->
<!--                    </a>-->
<!--                </li>-->
<!--            </ul>-->
<!--        </div>-->
<!--    </div>-->
    {/if}

    <!--    分成比例-->
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Divideinto')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-divideinto" class="form-control" step="0.01" name="row[divideinto]" type="number"  value="{$row.divideinto|htmlentities}">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            
            <div class="radio">
            {foreach name="statusList" item="vo"}
            <label for="row[status]-{$key}"><input id="row[status]-{$key}" name="row[status]" type="radio" value="{$key}" {in name="key" value="$row.status"}checked{/in} /> {$vo}</label> 
            {/foreach}
            </div>

        </div>
    </div>
    <div class="form-group">
        <label for="c-password" class="control-label col-xs-12 col-sm-2">{:__('Password')}:</label>
        <div class="col-xs-12 col-sm-4">
            <input id="c-password" data-rule="password" class="form-control" name="admin[password]" type="password" value="" placeholder="" autocomplete="new-password" />
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
